Managing Impulsive Behaviors With PTSD

If you have PTSD, you may be at a greater risk to engage in a number of impulsive behaviors, such as deliberate self-harm. Therefore, it can be important to learn healthy ways of managing urges to engage in these behaviors.

Impulsive behaviors are those that occur quickly without control, planning, or consideration of the consequences of that behavior. Impulsive behaviors tend to be connected with immediate positive consequences (for example, relief from emotional pain). However, in the long-term, there may be a number of negative consequences, such as greater emotional distress or regret.

In considering your behaviors, it may be helpful to think of some of the common serious impulsive behaviors with PTSD. Are any of these ways in which you are currently coping with emotional pain?

• Eating disorders
• Alcohol abuse or binging (self-medicating)
• Drug abuse (prescription or illegal)
• Self-harm
• Suicidal thoughts
• Gambling

There are a number of coping strategies available for preventing impulsive behaviors. If you struggle with impulsive behaviors, try one (or all) of the coping strategies below to see if you can get a better handle on problematic behaviors.

Urges to engage in impulsive behaviors may be very strong and hard to cope with. However, these urges generally pass fairly quickly. Therefore, if you can distract yourself when experiencing an urge, you may be able to sit with an urge until it passes. Fortunately, there are a number of healthy distraction strategies that may be helpful in riding out a strong urge or emotional experience.

Involve your senses in grounding techniques, basically a form of distraction, until you can replace impulsive behaviors with healthier behaviors.

Even though impulsive behaviors may lead to long-term problems, in the moment, they are serving a purpose. For example, they may help you cope with emotional pain. Therefore, one way of preventing impulsive behaviors is finding another, healthier behavior that may serve that same purpose. Healthy behaviors that could replace impulse behaviors include:

• Seeking out a friend
• Writing about your emotions. (check out the steps for journaling about your PTSD in this article)
• Meet with your therapy group or a friend from your group

Try to find a healthy way of relieving emotional pain that will not have long-term negative consequences for you.

We tend to be driven by the short-term consequences of a behavior. That is, we usually repeat behaviors that work well for us in the moment, regardless of what their long-term negative consequences are. Therefore, it can be useful to increase your awareness of the long-term negative consequences of a behavior. One way to do this is by identifying the short- and long-term pros and cons of a behavior.

People continue to engage in impulsive behaviors because they do something positive in the moment (for example, taking away anxiety or fear). One way to reduce the likelihood of an impulsive behavior is to take away its short-term positive effect. As soon as you engage in an impulsive behavior, immediately conduct a chain analysis to connect with why you engaged in that behavior in the first place. In a chain analysis, you try to connect all of the links between the behavior and the consequences. Steps may include:

• Identifying the behavior to change
• Identify what happened prior to the behavior you wish to change
• Evaluate your thoughts and feelings at that time
• Identify what your thoughts and feelings made you want to do
• Consider the consequences that occurred

This process will put you back in touch with all those emotions that you were trying to get away from in the first place and force you to face and cope with them in another, healthy way. It can also be very helpful to reward yourself when you don't engage in an impulsive behavior.

Bottom Line

Impulsive behaviors can be very difficult to cope with; however, it is possible. Identify some impulsive behaviors that you would like to change, and next time you notice an urge to engage in those behaviors coming on, try one of the coping strategies above. It may be difficult at first; however, with every success, it will become easier and easier to find healthy ways of coping with PTSD. Some of these strategies may include:

• Learning about your diagnosis
• Seeing a therapist (here are some tips on how to find a therapist if you do not yet have one)
• Join a support group
• Practice deep breathing exercises
• Practice self-monitoring